Exam 2

Question 1

What does Serum Bilirubin include?

Answer 1

Direct (0.1-0.3 mg/dL)
Indirect (0/2-0/8 mg/dL
Total (0.1-1.0 mg/dL)

Question 2

What is a blood test for Liver Disease?

Answer 2

Serum Bilirubin Test

Question 3

What serum bilirubin causes jaundice?

Answer 3

Total Serum Bilirubin >2.5 mg/dL

Question 4

What are the main Liver Tests?

Answer 4

AST and ALT

Question 5

What is albumin?

Answer 5

The most abundant protein

Question 6

Liver disease impairs what enzyme?

Answer 6

Albumin

Question 7

Low protein levels may cause what in the body?

Answer 7

Edema

Question 8

What is Gamma-glutamyl Transferase (GTT)?

Answer 8

A serum blood test for an enzyme that occurs in the liver

Question 9

What is asterixis?

Answer 9

When a patient’s wrists and fingers are observed to “flap”

Question 10

What is hepatitis?

Answer 10

An acute or chronic condition of liver inflammation

Question 11

How is hepatitis A spread?

Answer 11

Fecal or oral material. Oral and anal sex as well.

Question 12

How is hepatitis B spread?

Answer 12

Blood

Question 13

How is hepatitis C spread?

Answer 13

Blood to Blood

Question 14

Three ways Hep B is transmitted:

Answer 14

1. Infected blood, blood products, needles
2. Sexual transmission in semen or saliva
3. Infected mothers to child at birth

Question 15

Discuss Hep A treatment:

Answer 15

Self limiting. Clients generally recover in 4-6 weeks acquiring lifelong immunity.

Question 16

Hep B at risk for what?

Answer 16

Risk of liver cancer. Chronic hepatitis.

Question 17

Hep B vaccines?

Answer 17

Is recommended for infants, children, adolescents, and adults.

Question 18

Who has the greatest risk of developing Hep C?

Answer 18

Individuals who are IV drug users

Question 19

Hep C carriers can develop what?

Answer 19

50% develop chronic disease, 20% develop cirrhosis. Increased risk of liver cancer.

Question 20

Incubation period for Hep C?

Answer 20

5 - 12 weeks

Question 21

Incubation period of Hep B?

Answer 21

6 - 24 weeks

Question 22

Hepatitis treatments

Answer 22

• Immunoglobulin
• Peginterferon
• Interferon
• Antivirals

Question 23

Nursing considerations for Hepatitis

Answer 23

Private room, PPI (gown, gloves, goggles), disposable equipment, needless system, hand washing, screen blood donors, stool precautions for A, and test all pregnant women for B. No sharing toothbrushes.

Question 24

Diet for hepatitis

Answer 24

Provide high carbs, high calorie, low to moderate fat, low to moderate protein to promote healing. Small, frequent meals

Question 25

Liver abscess is what?

Answer 25

Caused by the spread of infection from some part of the intestinal tract

Question 26

Liver abscess S/S

Answer 26

chills, intermittent fever, extreme weight loss, nausea, vomiting, abdominal distention, right sided pain in abdomen and shoulder, jaundice

Question 27

Liver abscess Tx

Answer 27

antibiotics, percutaneous incision and drainage (I&D).

Question 28

Trauma S/S and Tx

Answer 28

orthostatic hypotension, low BP, tachycardia, shock. Surgery to control the bleeding.

Question 29

Trauma nursing considerations

Answer 29

Monitor VS, assess abdomen, treat shock, sterile technique, monitor drainage

Question 30

When is liver transplant necessary?

Answer 30

With life-threatening, end-stage liver diseases. May be total or a piece of the liver

Question 31

What is bile used for?

Answer 31

The digestion of fats.

Question 32

Where is bile produced?

Answer 32

In the liver

Question 33

Where is bile stored?

Answer 33

The gallbladder

Question 34

What is cholecystitis?

Answer 34

Inflammation of the bladder wall

Question 35

What is cholecysitits usually caused by?

Answer 35

Gallstones (cholelithiasis) that block the common bile ducts. Bile backs up and the gallbladder becomes inflammed.

Question 36

Disease prevention for cholecystitis:

Answer 36

Low fat diet rich in HDL sources (seafood, nuts, olive oil). Don't smoke. Participate in regular exercise program.

Question 37

Physical assessment findings:

Answer 37

jaundice, clay colored stool, steatorrhea (fatty stool), and pruritus

Question 38

incubation period for Hep A

Answer 38

2-6 weeks

Question 39

What is a cholecystectomy?

Answer 39

Removal of the gallbladder with a laparoscopic or open approach

Question 40

What is the drug Ursodiol used for?

Answer 40

Helps break up gallstones

Question 41

What is pancreatitis?

Answer 41

The enzymes activate prematurely before reaching the intestines. Results in inflammation, necrosis, and hemorrhage.